Henrikas Kazlauskas
Abstract
Summary
Due to the high morbidity and mortality and the consequences caused to the patient as well as to the society, the problem of treating patients with acute ischemic stroke has always been and remains one of the most important medical issues.
The aim was to examine the outcomes of the intravenous thrombolytic treatment of patients with acute ischemic stroke in Klaipeda university hospital for the period 2005-2010. The treatment results of 38 patients were investigated. Their average age was 63, men forming the majority (65.7 percent) of them. Intravenous thrombolysis with the recombinant tissue-type plasminogen activator alteplase (Actilyse) was used with a total dose of 0.9mg/kg; 10 percent of this dose was injected intravenously as a bolus, followed by an intravenous infusion of the remaining dose over 60 minutes. Medical record information (F 003) was used for the data analysis. Neurological state of patients before thrombolysis and after the treatment in time intervals, up to 3 months, was assessed using the National Institute of Health Stroke Scale (NIHSS). Complications of thrombolysis therapy were analysed. The data of the investigation were presented as percentage indicators. The results revealed that, during the analysis period only 1.8 percent (2110) of all acute ischemic stroke patients were treated with intravenous thrombolysis in Klaipėda university hospital. 24 percent of all patients treated with intravenous thrombolysis were admitted to hospital within 1-2 h after stroke onset, and 76 percent – within 2-3h accordingly. Following the treatment with intravenous thrombolysis, out of all patients who died of symptomatic intracerebral hemorrhage 2.6 percent died after 24 hours, 10.5 percent after 3 days and 13.1 percent after 7 days. It was found that the total cumulative mortality of these patients at 30 and 90 days (all patients, who were treated with thrombolysis and died were also taken into account), was 21.0 percent and 26.3 percent respectively. Following the intravenous thrombolytic treatment, more than one third of the patients were discharged to outpatient department with their independent functioning being fully restored. It was stated in the study conclusions that, during the analysis period, the number of patients treated with intravenous thrombolysis in Klaipėda university hospital was low. Mortality during the first week after thrombolysis found to be high; therefore, it is necessary to further improve in-patient stroke organisational care system. More than one third of the patients treated with intravenous trombolysis were discharged to outpatient department with their independent functioning being fully restored. It is necessary to continue improving public education that would help its members, who have become sick with acute stroke, to better recognise first symptoms of this disease and to seek for effective help the earliest possible.
Keyword(s): acute ischemic stroke, intravenous thrombolytic treatment.
DOI: 10.5200/106
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